Thymoma surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Amr Marawan, M.D. [2] Ahmad Al Maradni, M.D. [3]

Overview

Surgery is the mainstay of treatment of thymoma.

Surgery

• Complete resection may require resection of the adjacent structures, including pleura, lungs, pericardium, phrenic nerves and sometimes major vascular structures.
• Pleural surfaces should be examined for metastasis.
• There is no long term data to support minimally invasive procedures.
• A full median sternotomy is the standard open approach.
• The mediastinum must be explored for cervical thymus extensions and laterally down to the phrenic nerves.

Primary Diagnosis Treatment Algorithm

Stage I

**Diagnosis of thymoma

Resectable

Chemotherapy single agent e.g. IFo or combination e.g. ADOC or CAPP

Surgical resection

Incomplete resection

Radio/chemo therapy

Stage II/III/IV

Unresectable

Radiotherapy

Relapse Treatment Algorithm

**Relapse

Resectable

Unresectable

Radiotherapy

Corticosteroids/octreotide

Surgical resection

Incomplete resection

Radiotherapy